Single-arm feasibility trial of manualized outpatient morita therapy for panic disorder with agoraphobia

This single-arm feasibility trial evaluated the feasibility and safety of a manualized outpatient Morita therapy (MT) program for patients with panic disorder (PD) and agoraphobia in routine psychiatric care, and explored preliminary signals of symptom change.

Ten outpatients with PD and agoraphobia were enrolled in a 12-session manualized MT program. Feasibility outcomes included retention, attendance, and therapist adherence. Exploratory outcomes were the changes in scores of the Panic and Agoraphobia Scale (PAS), the Generalized Anxiety Disorder Scale-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Short Form-36 Health Survey (SF-36), assessed from baseline to the 6-month follow-up. Data were analyzed using linear mixed-effects models.

Feasibility criteria were met. The completion rate was 90%, with a mean attendance of 11.6/12 sessions. Therapists reported high manual fidelity and usability. Exploratory analyses showed improvements in PAS (Hedges' g = 1.53, 95% confidence interval [CI] 0.57-2.45) at 6-month follow-up, GAD-7 (g = 1.24, 95% CI 0.38-2.06), PHQ-9 (g = 1.05, 95% CI 0.25-1.80), and the Mental Component Summary of SF-36 (g = 1.71, 95% CI 0.68-2.70). The Role/Social Component Summary of SF-36 improved at post-treatment (g = 0.82, 95% CI 0.09-1.51) but not at follow-up (g = 0.45, 95% CI -0.19-1.06). No significant changes were observed in the Physical Component Summary of SF-36 (g = -0.14, 95% CI -0.72-0.46).

Manualized outpatient MT appears feasible and safe for patients with PD and agoraphobia. Preliminary effects on symptoms warrant confirmation in randomized controlled trials.